Gastrointestinal challenges in nephropathic cystinosis: clinical perspectives.

Gastrointestinal (GI) sequelae, such as vomiting, hyperacidity, dysphagia, dysmotility, and diarrhea, are nearly universal among patients with nephropathic cystinosis. These complications result from disease processes (e.g.

Vedolizumab Concentrations in Breast Milk: Results from a Prospective, Postmarketing, Milk-Only Lactation Study in Nursing Mothers with Inflammatory Bowel Disease.

Background And Objectives: The safety of inflammatory bowel disease medications during lactation is of significant relevance to women of childbearing potential. Available data regarding the transfer of biologic agents for inflammatory bowel disease via breast milk are limited to case reports. The objective of this prospective postmarketing lactation study was to assess vedolizumab concentrations in breast milk from lactating vedolizumab-treated women with inflammatory bowel disease.

Aspiration therapy for the treatment of obesity: 4-year results of a multicenter randomized controlled trial.

Background: The AspireAssist is the first Food and Drug Administration-approved endoluminal device indicated for treatment of class II and III obesity.

Objectives: We earlier reported 1-year results of the PATHWAY study. Here, we report 4-year outcomes.

Risk factors for small bowel bleeding in an overt gastrointestinal bleeding presentation after negative upper and lower endoscopy.

Introduction: A small bowel source is suspected when evaluation of overt gastrointestinal (GI) bleeding with upper and lower endoscopy is negative. Video capsule endoscopy (VCE) is the recommended next diagnostic test for small bowel bleeding sources. However, clinical or endoscopic predictive factors for small bowel bleeding in the setting of an overt bleeding presentation are unknown.

Percutaneous Gastrostomy Device for the Treatment of Class II and Class III Obesity: Results of a Randomized Controlled Trial.

Objectives: The AspireAssist System (AspireAssist) is an endoscopic weight loss device that is comprised of an endoscopically placed percutaneous gastrostomy tube and an external device to facilitate drainage of about 30% of the calories consumed in a meal, in conjunction with lifestyle (diet and exercise) counseling.

Methods: In this 52-week clinical trial, 207 participants with a body-mass index (BMI) of 35.0-55.

Northern Latitude but Not Season Is Associated with Increased Rates of Hospitalizations Related to Inflammatory Bowel Disease: Results of a Multi-Year Analysis of a National Cohort.

Background And Aims: There is growing evidence that the incidence and severity of inflammatory bowel disease (IBD) may be geographically and seasonally related. Why these associations are observed remains unclear. We assessed the impact of geographic location, season, and exposure to ultraviolet light on disease severity by measuring national hospital IBD-related discharge rates.

Obesity and Cardiovascular Risk in Adults With Celiac Disease.

Background: Patients with celiac disease (CD) may be at an increased risk of cardiovascular disease (CVD), yet CVD risk factors are not well defined in CD. The validated Framingham Heart Study 10-year general CVD risk score (FRS) that incorporates traditional CVD risk factors including body mass index (BMI) has not been previously studied in CD patients.

Aims: To compare BMI and FRS in CD patients with population-based controls.

Incidence and predictors of clinical response, re-induction dose, and maintenance dose escalation with certolizumab pegol in Crohn's disease.

Background: Certolizumab pegol (CERT) is indicated for reducing the signs and symptoms of Crohn's disease (CD) and maintaining clinical response. Patients losing response received an extra "capture" re-induction dose in the PRECiSE 4 study. We examined the use of certolizumab in a retrospective cohort of patients with CD at a single inflammatory bowel disease center.

A rapid and accurate method to detect active small bowel gastrointestinal bleeding on video capsule endoscopy.

Background: Video capsule endoscopy (VCE) is indicated to evaluate for suspected small bowel bleeding, but "standard view" (SV) evaluation is time-consuming. Rapid Reader 6.0 software (Given Imaging, Duluth GA) contains two computer algorithmic systems: (1) "Quickview" (QV) which automatically skips similar images and (2) a pixel analysis program that identifies suspected blood (SBI).

Comparison of efficacy, pharmacokinetics, and immunogenicity between infliximab mono- versus combination therapy in ulcerative colitis.

Background: The association of concomitant immunosuppressant use with infliximab (IFX) and therapeutic outcomes in correlation with pharmacokinetic properties in ulcerative colitis (UC) remains unclear.

Aims: To assess the effect of concomitant immunosuppressant use on the duration of IFX therapy, and the pharmacokinetic properties of IFX in patients with UC.

Methods: A retrospective analysis of UC patients treated with IFX.

Use of Serum Infliximab Level Prior to Cyclosporine Salvage Therapy in Severe Ulcerative Colitis.

Medical treatment options for severe, steroid refractory ulcerative colitis (UC) include infliximab (IFX) or cyclosporine (CSA), but general consensus has been that both agents should not be used together or even successively. We report a case of a 17-year-old male with severe UC refractory to IV steroids with successful sequential salvage therapy guided by serum IFX level. After primary lack of response to IFX, an undetectable serum IFX level and elevated IFX antibodies were followed by immediate transition to IV CSA.

Kin selection may contribute to lek evolution and trait introgression across an avian hybrid zone.

Understanding the mechanism(s) that favour cooperation among individuals competing for the same resources provides direct insights into the evolution of grouping behaviour. In a hybrid zone between golden-/yellow-collared (Manacus vitellinus) and white-collared (Manacus candei) manakins, males form aggregations composed of white and yellow males solely to attract females ('mixed leks'). Previous work shows that yellow males in these mixed leks experience a clear mating advantage over white males, resulting in the preferential introgression of yellow plumage allele(s) into the white species.

Discriminating inhalational anthrax from community-acquired pneumonia using chest radiograph findings and a clinical algorithm.

Background: Limiting the effects of a large-scale bioterrorist anthrax attack will require rapid and accurate detection of the earliest victims. We undertook this study to improve physicians' ability to rapidly detect inhalational anthrax victims.

Methods: We conducted a case-control study to compare chest radiograph findings from 47 patients from historical inhalational anthrax cases and 188 community-acquired pneumonia control subjects.

Unidirectional introgression of a sexually selected trait across an avian hybrid zone: a role for female choice?

Hybridization can be an evolutionary creative force by forming new polyploid species, creating novel genetic variation or acting as conduits of potentially advantageous traits between hybridizing forms. Evidence for the latter is often difficult to find because alleles under positive selection can spread rapidly across a hybrid zone and sweep to fixation. In Western Panama, an avian hybrid zone between two species of manakins in the genus Manacus exists where the unidirectional introgression of bright, yellow plumage into a white population provides evidence for the importance of hybrid zones as conduits of advantageous traits.

Prevalence of Clostridium difficile colonization at admission to rehabilitation.

Objectives: To assess the prevalence of intestinal colonization with Clostridium difficile (C. difficile) at admission to acute rehabilitation and to identify risk factors associated with colonization.

Design: Case-control study.

BRIEF REPORT: Factors affecting outpatient follow-up compliance of emergency department patients.

Background: Emergency department (ED) patients often fail to follow-up with referrals to outpatient clinics and physicians.

Objective: To compare the effects of 2 ED discharge instructional methods on outpatient follow-up compliance and to evaluate sociodemographic characteristics as possible factors affecting outpatient follow-up compliance.

Design And Participants: Randomized trial of ED patients.

Clinical predictors of bioterrorism-related inhalational anthrax.

Limitation of a bioterrorist anthrax attack will require rapid and accurate recognition of the earliest victims. To identify clinical characteristics of inhalational anthrax, we compared 47 historical cases (including 11 cases of bioterrorism-related anthrax) with 376 controls with community-acquired pneumonia or influenza-like illness. Nausea, vomiting, pallor or cyanosis, diaphoresis, altered mental status, and raised haematocrit were more frequently recorded in the inhalational anthrax cases than in either the community-acquired pneumonia or influenza-like illness controls.

Vitamin A deficiency in the late gastrula stage rat embryo results in a one to two vertebral anteriorization that extends throughout the axial skeleton.

Vitamin A and its metabolites are known to be involved in patterning the vertebrate embryo. Study of the effect of vitamin A on axial skeletal patterning has been hindered by the fact that deficient embryos do not survive past midgestation. In this study, pregnant vitamin A-deficient rats were maintained on a purified diet containing limiting amounts of all-trans retinoic acid (12 microg atRA/g diet) and given a daily oral bolus dose of retinol starting at embryonic day 0.